If Your Patient Has Gonorrhea, Make Sure You Treat Them With Ceftriaxone Plus Azithromycin

Contributing Editor

Nearly a fifth of providers nationwide fail to treat patients for gonorrhea with the recommended two-drug regimen, ceftriaxone plus azithromycin, that prevents the spread of a drug-resistant strain of the infection, the Centers for Disease Control and Prevention (CDC) reported last week.

The CDC analysis found that, in 2016, 81% of patients received the recommended treatment, with rates even higher for people who were treated in public or publicly funded sexually transmitted disease (STD) (91%) or family planning/reproductive-health (94%) clinics, such as Planned Parenthood sites, versus private settings.

"Our analysis underscored that STD and reproductive health clinics are providing quality STD care, as patients treated here were the most likely to receive the recommended treatment," CDC epidemiologist Elizabeth Torrone, Ph.D., told TheBody in an email. "Yet -- with nearly one in five patients [given] treatment that CDC does not recommend -- there is room for improvement. Health care providers must follow CDC's recommendations to slow the threat of drug resistance."

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According to Matthew Prior, senior communications manager for the National Coalition of STD Directors, the news is especially important because the U.S. is currently seeing record-high rates of gonorrhea. That may be due to better tracking, he says, but also, "We haven't seen an increased investment in STD prevention and control at the federal level in over 20 years." For adequate investment, he says, the federal budget would have to allocate about $70 million more to its current STD budget of $157 million, which is just a bit higher than the past 20-year flatline.

And, on the state and city level, Prior notes, a few years ago 40% of health departments reported reductions in STD clinic hours or staffing. "Often," he says, "these clinics are serving the most vulnerable populations with the lowest access to health care."

Thankfully, Prior says, the U.S. is not yet seeing dual drug-resistant strains of gonorrhea -- which, untreated, can spread to the blood or, in women, into the uterus or Fallopian tubes, where they can cause pelvic inflammatory disorder (PID).

But, he says, the recent emergence of such a case in the UK is "an alarm bell for us in the U.S. that it's only a matter of time before we see these dual-resistant strains, which lead to hospitalization and more intensive costs."

The best way to head off such strains, he says, is to make sure that 100% of gonorrhea cases are treated with the CDC-recommended two-drug regimen.